| NPI | 1497996656 |
|---|---|
| Doing Business As | COLONIAL MANOR |
| Entity Type | Organization |
| Authorized Contact | PEDRO BECERRA Owner/Administrator 757-476-6721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: VA 163W00000X) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |